Rheumatoid Arthritis

What is rheumatoid arthritis?

Rheumatoid arthritis, a chronic, autoimmune disease, is the most crippling form of arthritis and affects approximately 1.3 million Americans. This chronic disease is characterized by painful and stiff joints on both sides of the body that may become enlarged and deformed. Rheumatoid arthritis affects more women than men (75 percent of persons with rheumatoid arthritis are women). Onset of the disease is usually middle-age, but it does occur in individuals as early as age 20. Patients with rheumatoid arthritis may also have osteoporosis, a progressive deterioration of bone density.

Juvenile rheumatoid arthritis (JRA) is a form of arthritis in children ages 16 or younger that causes inflammation and stiffness of joints for more than six weeks. Unlike adult rheumatoid arthritis, which is chronic and lasts a lifetime, children often outgrow juvenile rheumatoid arthritis. However, the disease can affect bone development in the growing child.

What causes rheumatoid arthritis?

The exact cause of rheumatoid arthritis is not known. Rheumatoid arthritis is an autoimmune disorder, which means the body's immune system attacks its own healthy cells and tissues. The response of the body causes inflammation in and around the joints, which then may lead to a destruction of the skeletal system. Rheumatoid arthritis also may have devastating effects to other organs, such as the heart and lungs. Researchers believe certain factors, including heredity, may contribute to the onset of the disease.

What are the symptoms of rheumatoid arthritis?

The joints most commonly affected by rheumatoid arthritis are in the hands, wrists, feet, ankles, knees, shoulders, and elbows. The disease typically causes inflammation symmetrically in the body, meaning the same joints are affected on both sides of the body. Symptoms of rheumatoid arthritis may begin suddenly or gradually. The following are the most common symptoms of rheumatoid arthritis. However, each individual may experience symptoms differently. Symptoms may include:

inflamed membranes around the lungs (pleurisy), the sac around the heart (pericarditis), or inflammation and scarring of the lungs themselves, that may lead to chest pain, difficulty breathing, and abnormal heart function

swollen lymph nodes

Sjögren's syndrome (dry eyes and mouth)

eye inflammation

If a person has four or more of the following symptoms, he/she may be diagnosed with rheumatoid arthritis:

morning stiffness that lasts longer than one hour for at least six weeks

three or more joints that are inflamed for at least six weeks

presence of arthritis in the hand, wrist, or finger joints for at least six weeks

How is rheumatoid arthritis diagnosed?

Diagnosis of rheumatoid arthritis may be difficult in the early stages, because symptoms may be very subtle and go undetected on x-rays or blood tests. In addition to a complete medical history and physical examination, diagnostic procedures for rheumatoid arthritis may include the following:

Treatment for rheumatoid arthritis:

Specific treatment for rheumatoid arthritis will be determined by your physician based on:

your age, overall health, and medical history

extent of the condition

your tolerance for specific medications, procedures, and therapies

expectation for the course of the condition

your opinion or preference

The earlier a diagnosis is made and treatment is started, the more joint damage and impairment can be prevented. Treatment can range from simple therapies, such as diet and rest, to more aggressive therapies, including medications. Treatment may include: